Combined TMJ and Orthognathic Surgery

Temporomandibular joint disorders (TMJD) and dentofacial deformities often co-exist. One could be the cause or effect of the other. Orthognathic surgeries performed without management of active TMJD can risk unfavorable outcomes. Accurate diagnosis of TMJD and management is critical in patients with dentofacial deformities. Published studies show a significant number of OMS do not perform TMJ surgeries as part of their practice that could result in patient being treated with only orthognathic surgery or being referred to another practitioner. Traditionally, these conditions were treated in separate surgical encounters that increased morbidity and risks to patients. Recent data supports combining these treatments in appropriate patients when indicated could reduce morbidity of two procedures or risks from an untreated TMJD. Technological advances such as virtual surgical planning/3D printing have created ways for these surgeries to be done with precision, reduced surgical time and good outcomes. Combining these surgeries improves quality of care and patient convenience while decreasing risk from second general anesthesia. Combined surgeries are not done as commonly as conventional orthognathic surgeries, and OMS trainees and practitioners may not be familiar with the intricacies. This course intends to present indications, contraindications, planning, technique, risks and benefits related to these combined TMJ-orthognathic surgeries.

Learning Objectives

At the conclusion of this program, participants should be able to:

  1. Discuss indications and identify patient who could benefit from a combined TMJ-orthognathic surgery. 
  2. Describe the steps in planning/work-up for a combined surgery. 
  3. Explain the differences between a traditional orthognathic surgery and a combined surgery.

Shravan K. Renapurkar, DMD, FACS
Associate Professor, Program Director
Virginia Commonwealth University
Richmond, Virginia
Disclosure: No relevant financial disclosures.

An Internet-based CDE/CME Activity
Original Release Date: September 12, 2022
Expiration Date: September 12, 2025
Estimated time to complete this educational activity: 1.0 hours
Method of participation: Self-Study

Shravan Renapurkar, DMD, FACS

Associate Professor, Program Director

Virginia Commonwealth University

Dr. Renapurkar is an Assistant Professor in Department of Oral and Maxillofacial Surgery (OMFS) at Virginia Commonwealth University. He earned his Doctor in Dental Medicine (D.M.D) degree at Boston University. Prior to this, he completed a Bachelor of Dental Surgery degree at Government Dental College and Hospital, Hyderabad, India. He continued his education at University of Minnesota, where he completed a residency program in Oral and Maxillofacial Surgery. Prior to joining VCU as a full-time faculty in 2015, he pursued fellowship in Pediatric Oral and Maxillofacial Surgery at Massachusetts General Hospital, Boston, MA.Dr. Renapurkar has published several peer reviewed articles, book chapters, as well as lectured at local study clubs, state and national professional meetings. He is a Diplomate of the American Board of Oral and Maxillofacial Surgery, a Fellow of the American Association of Oral and Maxillofacial Surgeons, American College of Oral and Maxillofacial Surgery and American Society of Temporomandibular Joint Surgeons.He is involved with undergraduate and graduate OMFS education, and has been an active speaker for VCU School of Dentistry continuing education courses

Disclosures: No relevant financial relationships were disclosed.

Continuing Education Provider Approval
The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.

ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

The American Association of Oral and Maxillofacial Surgeons designates this activity for 1.0 continuing education credit(s).

AGD - Accepted Program Provider
FAGD/MAGD Credit
11/1/22-12/31/26
Provider ID# 214680

The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Association of Oral and Maxillofacial Surgeons designates this internet-based enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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